Clinical tips for the Management of Sinusitis

Sinusitis is the inflammation or swelling of the tissue lining the paranasal sinuses

It is also called rhinosinusitis

Definition

When sinuses become blocked and filled with fluid, organisms such as bacteria, viruses and fungi can proliferate in them CAUSING SINUSITIS

Sinuses are a four pairs of air filled cavities within the facial bones

They are lined with mucous membrane and trap dirt particles and bacteria

Causes of Sinusitis

• Viral such as common cold, Bacterial or Fungal• These cause swelling of the lining of the sinuses

blocking the openingInfection

• Allergens such as Pollen, Irritants such as Chemical sprays, smoke

• Exposure to these can inflame lining of the sinusesAllergy

• Enlarged Adenoids, Nasal polyps, Deviated nasal septum

• These can impede the drainage of sinuses into the nasal cavity

Structural abnormalities

• Diseases such as Cystic Fibrosis• Exposure to irritants such as cigarette smokePredisposing factors

Clinical types

Sudden onset of runny,

blocked nose ,with facial pain

lasting upto 2-4weeks

Symptoms of sinusitis lasting for 4-8 weeks

Symptoms lasting for

more than 8 weeks

Several attacks within a

year

Acute sinusitis Sub-acute Sinusitis Chronic sinusitis Recurrent Sinusitis

Symptoms of Sinusitis

Acute Sinusitis

Nasal blockage Nasal discharge Facial

pain/tenderness Loss of smell Cough Fever Bad

breath(halitosis) Fatigue Dental pain

Facial pain/ congestion/ sensation of fullness

Nasal obstruction Fever Discoloured

nasal/post nasal discharge

Headache Bad breath Fatigue Dental pai

Chronic Sinusitis

Diagnosis

Physical examination-Facial Tenderness may be present

X- ray( paranasal sinus radiography) –Normal sinuses look black on x-ray, in sinusitis a dense white /grey shadow indicating an air-fluid level

Mucous culture may reveal the causative organism

Nasal endoscopy/CT Scan/MRI may also be used

Allergy tests to identify specific allergens

Complications

• Meningitis, Brain abscess

• Spread of infection to the orbit can cause reduced/lost vision, orbital cellulitis

• It may trigger asthma attacks

• Facial osteomylitis• Cavernous sinus

thrombosis

Though rare,

Chronic sinusitis

can cause some

complications

Homoeopathic treatment is effective in Acute and Chronic Sinusitis

In Acute phase, totality of symptoms must be used as a guide to choosing the remedy, exciting cause should also be considered

During the disease free period the a well chosen constitutional, anti-miasmatic remedy goes a long way in correcting the dyscrasia

Homoeopathic Management

Remedy Indications

ARSENICUM ALBUM Throbbing and burning pains in the sinuses< by light, noise, movement, after midnight, > by lying quietly in a dark room with the head raised on pillows and warmth application. Nausea and vomiting concurrent with sinusitis. Great thirst, desire for drink in frequent sips, rather than gulps

ARSENICUM IODATUM Tubercular Diathesis, Dull, heavy headache, < occiput Eyeballs feel heavy, Foul otorrhœa, Persistent, but unsatisfactory sneezing, Nose drips water, hot , green, acrid, reddens upper lip, Coryza; with dyspnœa , post-nasal catarrh, Colds with hunger, Aching malar bones

ARUNDO Deep seated pain in sides of head with painful roots of hair, Coryza accompanied by marked itching in the nostril & roof of the nose, Temporary loss of smell.

BELLADONNA Throbbing frontal headache < by jarring, touch, bending forward, or motion of the eyes and > pressure and in semi erect posture, Pain appears suddenly , then disappears temporarily, only to repeat the process of coming and going ,ailments from least exposure to cold.

ECHINAECIA Foul smelling discharges, membranous formations protruding, nose feels stopped up

ELAPS CORALLINES In chronic cases, with chronic nasal catarrah with fetid odour & greenish crusts, Pain at the root of nose , Nose blocked, < cold drinks, wet weather, eating fruits

Homoeopathic therapeutics for

SINUSITIS1

Remedy Indications

EUCALYPTUS Rheumatic-Hydrogenoid constitution, Stuffed-up sensation, thin, watery coryza, nose does not stop running, tightness across nose bridge, Chronic catarrhal, purulent and fetid discharge, Ethmoid and frontal sinus involved. Dull congestive headache

FAVUS Pain in Frontal and Maxillary sinuses, Dry with dry crust, Discharge of greenish pus < Morning, > in morning after sneezing

FORMICA RUFA Marked deterrent on the formation of Nasal Polyp, Blocked sensation of NASAL POLYP

HEDERA HELIX Pain of the Ethmoidal and Frontal sinus. Inflammation of the frontal sinuses with headache. Nasal discharge < Hot room

HEPAR SULPH Rarely indicated at the beginning of a sinusitis. Nasal discharge is thick and yellow. Nostrils become very sore from the acrid discharge, and the nasal passages become sensitive to cold air

HIPPOZAENIUM Discharge acrid, corroding, bloody, offensive. Papules and ulceration in frontal sinus and pharynx

HYDRASTIS Chronic sinusitis where there is thick, tenacious yellow secretion from posterior nares to throat. Dull, pressive frontal pain, especially associated with constipation. Also useful in acute cases. Sinusitis after suppressed coryza

Homoeopathic therapeutics for

SINUSITIS2

Remedy Indications

INFLUENZINUM Polysinusitis with history of Influenza

IODUM Pain at the root of the nose, with nasal blockage

KALI BICHROMICUM Syphilitic or Scrofulous background. More adapted to sub-acute rather than acute violent stages, Pressure and pain at root of nose, and sticking pain in nose. Septum ulcerated, round ulcer. Fetid smell. Discharge thick, ropy, and greenish-yellow. Tough, elastic plugs from nose, leave a raw surface, Inflammation extends to frontal sinuses, with distress and fullness at root of nose, Dropping from posterior nares, Loss of smell. Hawking, Inability to breathe through nose, Dryness, Coryza, with obstruction of nose, Violent sneezing. Profuse, watery nasal discharge, Chronic inflammation of frontal sinus with stopped-up sensation , Fontal pain usually over one eye

KALI IODATUM Syphilitic background, incipient organic changes. Tip of nose red; profuse, acrid, hot, watery, thin discharge. Ozæna, with perforated septum. Sneezing. Nasal catarrh, involving frontal sinus. Stuffiness and dryness of nose, without discharge. Profuse, greenish, irritating discharges. Intense pain over eyes and root of nose

LACHESIS Severe frontal headache after cessation of nasal discharge. Pain > after flow begins. Bloody discharge

Homoeopathic therapeutics for

SINUSITIS3

Remedy Indications

LUFFA OPERCULATA Acute or chronic inflammation . Dryness of the nasal mucous membrane with adhering crust formation,< confined air, > Fresh air of the outside

MENTHOLUM Frontal headache, pain over frontal sinus, descends to eyeballs. Supra orbital pain over left eye. Pain in face above zygoma with numbness. Pain in eyeballs. Coryza with post-nasal dripping. Cold sensation in nose. Eustachian tubes feel blocked and some deafness. Short, dry cough, worse smoking. Asthmatic breathing, with congestive headache

MERCURIUS SOLUBILIS Thick, greenish, offensive, acrid nasal discharge. Sensitive to both heat and cold. Profuse perspiration without relief. Tongue is flabby with imprint of teeth, profuse salivation, and foul breath.

NAT MUR Suitable for early stages with symptoms like sneezing, loss of smell and a blocked sensation with watery discharge. Throbbing frontal headache

NUX VOMICA Treats symptoms of sinusitis where sneezing and runny nose are frequent by day, but nose stopped at night, and it is not uncommon for a patient to wake up with complaints around 3-4 a.m,<in warm room, > in cold air

PENTHORUM Constant wet feeling in nose with no amount of blowing will relieve. Discharge thick, pus-like, streaked with blood. Post nasal cattarh of puberty

PENICILLINUM Right Frontal Sinusitis. Right sided frontal headache. Discharge is yellow, thick, < Humid cold weather, > Warmth

Homoeopathic therapeutics for

SINUSITIS4

Remedy Indications

PNEUMOCOCCINUM Pain on Left Frontal Sinuses, Sub-orbital frontal pain < Humid weather, > Open air

PULSATILLA Headache <in a warm room and better in open air, cold application & pressure. Pain rapidly shifting from one part to another. The nasal discharge is thick, bland & yellowish-green. Marked thirstlessness.

PYROGEN Pansinusitis with fever, headache, Mostly the sphenoidal sinus is involved

SABADILLA Spasmodic sneezing, with running nose. Coryza, with severe frontal pains and redness of eyes and lachrymation. Copious, watery, nasal discharge. Sensitive smell. Pain in alternate sides of forehead. Unilateral head pains. Tongue feels burning sensation

SILLICEA Indicated for chronic sinusitis, chronic congestion accompanied by headache that tends to be worse in the right eye. Pain is < by cold, movement, light, noise, and mental concentration (such as when studying), uncovering the head but > by wrapping warmly and pressure

SPIGELIA Forepart of nose always dry, discharge through posterior nares chronic catarrh, with post-nasal dropping of bland mucus. Fetor oris. Left supra-orbital or occipital pain; boring

STICTA PULMONALIA Feeling of fullness at the root of nose. Dryness of nasal membrane, constant need to blow the nose, but no discharge. Dry scabs, especially in evening & night. Dull headache, with dull heavy pressure in forehead & root of nose before discharges appear

Homoeopathic therapeutics for

SINUSITIS5

Eucalyptus Q Ocimum sanctum Q Hydrastis Q

Mother tinctures used for inhalation

Steam inhalation using water medicated with 15-20 drops, 2-3 times daily.

Steam inhalation with water medicated with mother tinctures like Hydrastis, ocimum sanc & Eucayptus

Use a humidifier in the room Drinking lots of fluids helps to keep the mucus

thin, preventing their blockage Jal and Sutra Neti , the yogic technique of

flushing out the nasal passages & sinuses using salt water and thread may help

Use a nasal saline solution. While they don't contain medicine, they can help keep your nasal passages moist

Flush out the sinuses. Nasal irrigation with salt water can clear out mucus (and other debris) and keep sinuses moist

Putting a warm, wet towel on the face may help relieve some of the pressure

General Measures

Dr Ashok Sharma, CMO Dr Jithesh T.K, C.M.O Dr Prasad Mahajan, CMO Dr Pradip Kumar Roy, S.M.O Dr Ram Kumar, SMO Dr Malay Kumar Ray, M.O Dr Cheshta Nagrath, M.O

Dr Deepti ChawlaC.M.O, Dte. of AYUSH

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